Jeremy Laurance

Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.

If you are going to be sick, be sick soon – as the NHS may never be so good again.

The respected health policy think tank, the Kings Fund, says that after a decade of unprecedented growth NHS performance is “holding up well” with waiting times for operations at a record low, hospital infection rates plunging and mixed sex wards almost eliminated.

But it warns “treacherous waters” lie ahead as the financial squeeze tightens and cracks are beginning to appear, with lengthening waits in Accident and Emergency, rising emergency admissions of the elderly and 27 NHS trusts in financial difficulty.

The NHS has been set a target of saving £20 billion by 2015 but most experts believe more savings on the same or a larger scale will be required in the decades beyond and the squeeze on its budget will remain in perpetuity.

Jeremy Hunt, the health secretary, will attempt to stop the rot by announcing today plans to introduce Ofsted style inspections of hospitals and care homes to ensure quality does not suffer as budgets shrink.

Under current rules, NHS trusts and care homes have to meet minimum standards policed by the Care Quality Commission but following scandals at Mid Staffs NHS trust, where hundreds died because of poor care, and Winterbourne View, where people with learning disabilities were punched and kicked by staff, Mr Hunt believes the current rules do not go far enough.

The Nuffield Trust is to conduct a review examining how to give the public a simple means of judging the quality of a hospital or care home and will report by March.

The Kings Fund assessment of the NHS at the halfway point through the coalition’s term, says that despite ministerial claims to shift power from the centre much of the previous target-driven system is still in place.

The huge organisational change involved in implementing the reforms, which shift control of a large portion of the NHS budget into the hands of GPs, has led to the loss of experienced managers and put the future of the NHS at risk.

Anna Dixon, director of policy, said: “Neither competition nor commissioning reform alone can be relied on to make the improvements needed. Fundamental change will be required to meet the challenges of the future.”

Andy Burnham, Labour’s shadow health secretary, said: “The Government has placed the NHS in a precarious position. They have taken unacceptable risks with patient care by reorganising the NHS at a time of financial stress.”